1336316991 NPI number — DR. NARMIN FARAH HUSSAIN MIZAN MD

Table of content: DR. NARMIN FARAH HUSSAIN MIZAN MD (NPI 1336316991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336316991 NPI number — DR. NARMIN FARAH HUSSAIN MIZAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MIZAN
Provider First Name:
NARMIN
Provider Middle Name:
FARAH HUSSAIN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUSSAIN
Provider Other First Name:
NARMIN
Provider Other Middle Name:
FARAH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1336316991
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/28/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
579A CRANBURY RD
Provider Second Line Business Mailing Address:
UNIVERSITY RADIOLOGY GROUP, PC
Provider Business Mailing Address City Name:
EAST BRUNSWICK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08816-5426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-390-0040
Provider Business Mailing Address Fax Number:
732-390-1856

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
579A CRANBURY RD
Provider Second Line Business Practice Location Address:
579A CRANBURY ROAD
Provider Business Practice Location Address City Name:
EAST BRUNSWICK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08816-5426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-390-0040
Provider Business Practice Location Address Fax Number:
732-390-1856
Provider Enumeration Date:
05/13/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  049629 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 265587 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 25MA09158500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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